MATERNAL AND NEONATAL OUTCOME OF ADVANCED MATERNAL AGE ADMITTED FOR LABOUR AND DELIVERY IN ACSH AND MGH

Abstract

Background Advanced maternal age is usually defined as being 35 years or older during pregnancy. AMA, planned or unplanned, are usually regarded as high risk, because they have been associated with an increased risk of adverse pregnancy outcomes. Objective To examine maternal and neonatal outcomes in AMA admitted for labor and delivery at AMA and adult age pregnancy in ACSH and MGH , from July 2024 to October2024 Methodology Hospital based prospective case-control study on 256 pregnancy at AMA(cases) and 256 pregnancy at 20-34yrs(controls) admitted for labor and delivery in Mekelle Public Hospitals was employed. Data was collected by using pretested structured questionnaire. The collected data was entered into EpiData 4024 and exported to SPSS 27 for analysis. The dependent variables were AMA pregnancy, maternal and neonatal outcomes. Statistical significance declared at p<0.05. Result Participants who attended secondary school or above accounted for 144 (56.3%) of cases and 185 (72.3%) of controls. The difference in distribution of educational status between cases and control were statistically significant (p=0.001). Among those who had ANC contacts, 4 plus ANC contact was recorded in 188 (76.1%) of cases and 220 (87.6%) of controls and the difference was statistically significant (p<0.001). Pregnancy was planned in 218 (85.2%) of cases and 248 (96.9%) of controls. The difference in pregnancy plan was statistically significant (p<0.001). Obstetric complications happened in 104 (40.6%) of cases and 70 (27.3%) of controls. The magnitude of obstetric complication was significantly higher in cases group (p=0.002). Caesarean delivery rate was higher in cases (87, 34.0%) than controls (53, 20.7%) and the discrepancy was highly remarkable (p<0.001). The magnitude of low first minute APGAR score (<7) was observed in 27 (10.6%) of cases and 10 (3.9%) of controls. This difference was statistically significant (p=0.011). Conclusion This study has revealed that obstetric complications like antepartum haemorrhage, pre-eclampsia, prolonged labor, and gestational diabetes are higher among older mothers compared to younger mothers. Low First minute APGAR scores were more frequent in older mothers. Caesarean delivery and post-partum haemorrhage (PPH) were significantly higher in mothers aged 35 or above.